Exercises for runners with knee pain

Exercises for runners with knee pain

I have found that there are a few key exercises that have been invaluable to the runners that I see and work with here in Seattle.

Things you need to know about transgender athletes

Things you need to know about transgender athletes

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It’s pride month and there seems to be no better time to be engaging in conversations around transgender athletes. I know that this is a politically charged topic and one which can be difficult to have, but nothing can be quite as difficult as living as a trans person in this world. So without further ado, let’s get on with what you need to know.  

 


Transgender athletes are human beings

This fundamental truth is not up for debate. Transgender people are human beings, worthy of love and respect in this world.


Research does not demonstrate that transgender athletes have a distinct competitive advantage

I imagine this one is hard for many people to believe, but at the moment, the literature and body of evidence we currently have on transgender people, does not appear to demonstrate that they have a clear and distinct competitive advantage in sport (Jones et al. 2017).

The reality is that this remains to be answered and continues to be ambiguous in nature (Reeser 2005).

When you consider the entirety of our world population, the number of transgender people who make it to the sporting level is actually quite low, in part because sport governing bodies are still at odds with how to be inclusive.  

Since the implementation of Title IX, girls sports participation has jumped from 295,000 to nearly 3.2 million in 2011 (and that was 8 years ago). I could not find the number of transgender athlete participation, but I’ll share this, the number of more ‘well-known’ transgender female athletes (MTF) is 28 total athletes worldwide. I’ll say it again, 28 transgender athletes worldwide that are more ‘well-known.’ And this is across a range of different sports from powerlifting, to cricket, to roller-derby, to Thai boxing, to darts.

The media draws some attention towards transgender athletes at the high school level, in part because we still don’t have clear solutions to making things “fair.”  High school is frequently when these individuals are figuring out their identities and potentially starting to consider how to transition.

But fairness in sport has actually never been a thing. Is it fair that Michael Phelp’s was born with bigger lungs than most normal people? Probably not, but you don’t see sport governing bodies regulating his body so that it’s “fair” for other male athletes.

The majority of transgender individuals have a negative experience in sport and transgender athletes are not consistently and reliably winning.

As a female athlete who can relate to access issues, motivational issues in sport and negative experiences overall ranging from discouragement to unwanted comments about my body, I can say that these negative experiences impact performance, as well as participation to a great degree.


Caster Semenya is not a transgender athlete

For those of you who aren’t familiar with the controversy surrounding this particular female athlete, Caster Semenya, I encourage you to read up on it here.

For those of you that are somewhat familiar, I want to make it clear that Caster Semenya is NOT a transgender female athlete. Semenya was born a female, and was assigned female at birth. Semenya was born with differences of sex development (DSD) and has naturally higher levels of testosterone as a result of hyperandrogenism and XY chromosomes. She simply highlights the nuances of clear sex definitions and how difficult it can be when an athlete has DSD.

The hormone, testosterone, has largely been labeled as the “male hormone,” but the truth here is that female athletes have varying levels of testosterone as well (Tannenbaum and Bekker 2019).

Testosterone levels are thought to be the sole reason for performance or competitive advantage in sport. If this is the case, one might argue that regulating it in male athletes would be necessary to ensure a “fair” playing field.

The regulation of female athlete bodies has been a problem since the 1940s, when female athletes were, at times, required to have surgical interventions to their sex organs and traits to fit gendered norms and biases (Karkazis and Jordan-Young 2018). These discriminatory practices and policies persist today and impact not only the athletes these policies are directed towards, but female athletes as a whole (Karkazis and Carpenter 2018).

This sets the precedent for continuing to normalize the regulation of female bodies and it’s not ok.


Transgender athletes are not primed to be successful in sport

From discriminatory policies, to outright bans, to violence against transgender people, to social outcasting, these athletes are not put in the best position to succeed. At the highest levels of sporting participation, these athletes are being regulated and banned.

It’s important to consider that as a female athlete, incentives and access to continue to play at high levels are slim. In soccer we see gross differences in male to female athlete pay, in professional running, we see sponsors like Nike unwilling to continue an athlete’s contract if she gets pregnant.

Being a high level athlete as a female is HARD. Aside from the physical characteristics it takes to succeed, it takes a certain level of grit, commitment, and drive. Characteristics that are hard to come by in any level of sport. Incentives for transgender athletes to continue to participate in sport are even more slim. The likelihood that a transgender person makes it to these levels is poor at best.


Discriminatory sporting policies are rooted in misogyny and racism

The unfortunate reality is that these policies impact women of color disproportionately (Cooky and Dworkin 2013; Erikäinen 2017). They are based on the idea that the male athlete is superior and the female athlete is inferior.

The systems of oppression in sport are real and they impact all of us on some level, but there has been no people more impacted by these policies than women of color.


Resources & References

  1. Cooky, Cheryl, and Shari L. Dworkin. 2013. “Policing the Boundaries of Sex: A Critical Examination of Gender Verification and the Caster Semenya Controversy.” Journal of Sex Research 50 (2): 103–11.

  2. Erikäinen, Sonja Tuulikki. 2017. Policing the Sex Binary: Gender Verification and the Boundaries of Female Embodiment in Elite Sport.

  3. Jones, Bethany Alice, Jon Arcelus, Walter Pierre Bouman, and Emma Haycraft. 2017. “Sport and Transgender People: A Systematic Review of the Literature Relating to Sport Participation and Competitive Sport Policies.” Sports Medicine  47 (4): 701–16.

  4. Karkazis, Katrina, and Morgan Carpenter. 2018. “Impossible ‘Choices’: The Inherent Harms of Regulating Women’s Testosterone in Sport.” Journal of Bioethical Inquiry 15 (4): 579–87.

  5. Karkazis, Katrina, and Rebecca M. Jordan-Young. 2018. “The Powers of Testosterone: Obscuring Race and Regional Bias in the Regulation of Women Athletes.” Feminist Formations. https://doi.org/10.1353/ff.2018.0017.

  6. Reeser, J. C. 2005. “Gender Identity and Sport: Is the Playing Field Level?” British Journal of Sports Medicine 39 (10): 695–99.

  7. Tannenbaum, Cara, and Sheree Bekker. 2019. “Sex, Gender, and Sports.” BMJ  364 (March): l1120.

Achilles Tendinopathy

Achilles Tendinopathy

Two years ago I sustained an achilles tendon injury resulting in tendon pain with activity, specifically running.

Stress Fractures in Female Runners

Stress Fractures in Female Runners

Under the pretense of Wolff’s law, one might deduce that as long as your bones are healthy (key word here...healthy), they’ll adapt to the stressors you place on them and even become stronger.

So your low back "went out."  What now?

So your low back "went out." What now?

Have you ever “thrown out your low back?” Are you wondering what you can do to help?

Confessions

Confessions

As I look back on my time as a physical therapist, I am haunted by the harm that I am certain I caused.

3 Common Training Pitfalls made by Female Runners

3 Common Training Pitfalls made by Female Runners

The most common misconception among female runners/athletes is that heavy lifting will make you get big.

Dear Runner’s World, Women’s Health & Amanda Mccracken

Dear Runner’s World, Women’s Health & Amanda Mccracken

Day after day I am confronted with the sad reality that our medical system has created a sense of fragility in women all over the country.

Are you having low back pain with deadlifting?

Are you having low back pain with deadlifting?

Are you having low back pain with the deadlift exercise?

#SISUSeattleACL Part 1: Removing Seeds of Doubt Following ACL Surgery

Doubt, is death to dreams for women and girls.

Clamshells, the lettuce of exercises

I am, on the other hand, flexible to change and I lean in to the new things I learn as much as I can. As such, with everything new I know about helping people through recovery, the clamshell exercise has become my newest piece of garbage, that likely needs to be thrown out.

Enough already.

I need to talk about this slide.

 5 Tips For Better Self-Management of Plantar Fasciitis for Athletes

5 Tips For Better Self-Management of Plantar Fasciitis for Athletes

Out with the old and in with the new! Plantar foot pain is hard enough as it is, we don’t need to be torturing ourselves anymore than necessary. 

10 Benefits of Strength Training for Runners

 

Hey runners! Let's talk about load (ie. strength training). Strength training is a valuable asset to a runner's training regime for a number of different reasons, but too often strength training is non-existent in a runner’s routine. While each person is different and may require different exercises or habits, in my practice as a physio, strength training is a necessary and complimentary add to a runner’s routine and the benefits are robust.

Here are my top 10 reasons why a runner should be implementing strength training into their routines:

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  1. Increased strength

  2. Increased tissue tolerance

  3. Added training variability

  4. Enhanced movement coordination and control

  5. Improved bone density

  6. Improved cardiovascular health

  7. Improved reactive strength

  8. Improved VO2 Max

  9. Improved economy

  10. It helps you to feel like a badass

I tend to recommend that runners perform strength training 2-3 times per week in their low seasons or off seasons and as mileage ramps up, reducing that down to 1 time per week during peak training. Studies have demonstrated that being able to maintain 1 time per week during peak training, continues to foster the benefits listed above.  

 

Fear-Avoidance Model

 

Injury, and the pain that follows, can be a scary experience. But it doesn't have to be. We will often go searching for information to help us understand what has happened or what may be happening to cause our pain. Unfortunately, that information much of the time, is frightening, scary and downright bad.  

As it turns out, frightening or threatening information from the internet, the media, your friends, your family, and even from your healthcare provider, can feed a cycle that may keep you from a full recovery. 

My job is to use the knowledge I have to foster resilience and joy. This means providing you with a better understanding of your body, what is happening, and how it can get better. We are, after all, incredible at learning and staying alive after an injury!

The video below provides a very simple explanation of how positive feedback can foster recovery after injury and how I use positive feedback to do just that.

Have a watch!

 

New blog with Girls Gone Strong!

If you haven't done so yet, check out the new blog I wrote for Girls Gone Strong on movement variability! 

--> Click here to read the article <--

Highlights:

  • "Variability in our movements and posture is important, because of the need for our bodies and minds to tolerate day to day activities, without needing to think about what our spine is doing during those activities."
  • "By simply telling someone that bending over is “bad” for them, we create an environment that lends itself to fear. Fear of one’s own body and how to use it."
  • "Adding variability into our day gives us the opportunity to explore and get curious about what our body can do and in what positions it can do it."
  • "If someone were to ask me why movement variability is so important, my answer would be simple: for perspective."
  • "When we encourage women and girls to believe that perfect posture is the one and only answer to reducing their pain, to being able to lift a weight off the ground, or to developing the assurance to ask for a raise, we ultimately diminish their ability to feel comfortable and confident enough to get in the gym, explore, create and discover their truest selves."
  • "Movement variability provides us with an opportunity to gain confidence, learn new skills, test the limits of our body and our mind, as well as break down old belief systems and build up new ones."

Cheers all!

Dr. Ellie Somers, PT

"Physio on a mission 💪"

 

Good posture is BS and here's why...

 

     I recently had a conversation with a woman and her husband. The woman, is a well-intentioned person with a good heart, looking to do what is best for her husband. Knowing that I was a physical therapist, she decided to walk over to me with her husband in the hopes that I would help convince him that he needed better posture and that he needed to put efforts into improving it. 

My beautifully, imperfect posture

My beautifully, imperfect posture

 

When they first walked over, I was asked to simply stand in place. The hope, I’m pretty sure, was that I would demonstrate “perfect posture” for this gentleman. But alas...I do not have perfect posture. I have forward shoulders, anterior pelvic tilt, thoracic spine kyphosis, and probably some other “imperfections” that I’m not even aware of and that I could care less about.

 

After seeing my posture, her husband asked me to “stand up straight.” I did so and at the same time, I said “well that’s not comfortable for me.” He looked at his wife and said, “see??” A bit confused, she told him that better posture would be helpful for him. When he looked at me, I said, “well how do YOU feel?” What he said next, was like a breath of fresh air for me. He said, “I think, I am the way I am.” And I said, “I agree.”

This picture is just absurd and I felt it was important to include

This picture is just absurd and I felt it was important to include

 

“I am, the way I am.” So many reasons to love a statement like that.

 

Here’s the deal, we grow like trees. ALL of us have “perceived” flaws and asymmetries. Areas we feel we need to “improve” or whatever. When it comes to posture, our society has been crippled by the belief that posture is why we have pain and why we have “degeneration” in our spines. It’s a load of crap.

Most of the time, my posture looks like this...it means nothing.

Most of the time, my posture looks like this...it means nothing.

 

Some of us have rounded shoulders, some of us have broad shoulders, some of us have conditions that CHANGE the way we look from the outside, like kyphosis or scoliosis. But good posture never improved someone’s strength. Good posture, doesn’t dictate a person’s level of health. Good posture doesn’t improve joint function. Good posture, is bull shit and what we call "bad posture", sure as hell doesn’t prime you for a life a misery.

 

When it comes to posture, the research clearly shows us it means almost nothing. Posture is a piece of a puzzle that has billions of pieces to it. That puzzle is called the human condition. And humans are complex!! I wish I could say that posture was a cure all, as so many tend to believe, but posture means very little about a person’s well-being, their risk for pain, or their risk of “damage” to themselves.

 

I don't usually move this way, but it was fun!

I don't usually move this way, but it was fun!

You see, our bodies were meant to be put into weird positions. They can withstand great forces from all kinds of directions. In fact, if we take a look at the research on scoliosis, we’ll find a very weak link to pain. How can that be? It can be, because our spines are strong and resilient. It can be because each of us is different. Because ‘we are the way we are.’ Because our bodies are friggin amazing.

 

So, quit being hard on yourself. Quit being hard on others. Be in this world whatever way you want. Standing tall or hunching over a computer. Twist yourself into a pretzel if you wish. Do a back-bend, do a forward bend. Do it ALL. Sit the way that is most comfortable. Your body is fabulous.

 

Cheers,

Dr. Ellie Somers, PT, DPT

"Physio on a mission"

 

#EntropyWest

 

When I started Sisu Sports Performance & PT in Seattle, I made a very deliberate decision to support women to the best of my ability within my business. This meant, offering better care options for women but also supporting women-owned businesses, to the best of my ability, in every way.

Gaining access to high quality continuing education opportunities as a physical therapist can be challenging and while programs like MedBridge offer some excellent opportunities through online learning, it can be tough to filter through the endless number of courses to find quality education. Not only that, but I craved personal connection. I wanted to MEET the most highly regarded providers in the world. To be challenged through thought, intellect and personal connection.

When it came to my education as a professional, I wanted to learn from the best, and as it turns out, some of the most decorated women in physical therapy were offering the quality continuing education courses that had me drooling. The only problem, was that they were offering these courses in Chicago and I live in Seattle.

So, after a few adult beverages, I decided to reach out to Sarah Haag of Entropy Physiotherapy & Wellness, in the hopes of convincing her and Sandy Hilton to agree to partner with me. I fully admit, this ask was a selfish one. I wanted better learning opportunities here in the Northwest. Much to my surprise, she said yes. It felt like a marriage proposal of a lifetime and I quickly became the luckiest woman in the world. It was shortly after that, that I decided to reach out to my old colleague and friend, Paige Raffo, the owner of Balance & Flow Physio, to facilitate this opportunity by providing the right clinic space. 

Entropy brings in world class physical therapists including names in the likes of: Julie Wiebe, Christopher Johnson, Jessica Davis, Greg Lehman, Adam Meakins, Erik Meira and let us not forget, the owners themselves, Sandy Hilton and Sarah Haag.

These courses, brought in by two of the most impressive women in our field, are a result of the network of people they have all over the world. Opportunities like this do not exist anywhere other than Chicago and now the Seattle-area. I am incredibly honored and proud to support their mission to bring, as their tagline states, 'world class continuing education' opportunities to healthcare providers, now in the Pacific Northwest.

“It’s not just the content of the courses, it’s the conversations that happen during and the people that comprise them.”
— Entropy

These courses offer the opportunity to connect with other physios from around the world.  We have four courses lined up for 2018 and are bringing in professionals as far reaching as Australia. We offer lunch and snacks at each of our courses, as well as provide the opportunity to network and connect afterwards.

I am very excited for what we have in store and for the people I get to meet this year! And...I very much look forward to connecting with you in 2018 at an #EntropyWest course!

For more information, head to my ‘Events’ page for sign up links and course descriptions, sign up for my newsletter below or go straight to the Entropy Physiotherapy & Wellness website to register.

If you have any questions, do not hesitate to reach out! I am happy to be a resource for you!

Cheers,

Dr. Ellie Somers, PT, MSPT, DPT

Great exercises for female athletes with knee pain

...about 25% of athletes with anterior knee pain will stop participating in sports because of their pain

Girls Gone Strong Article

Being curious about the sensation of pain, and how the entirety of our personhood might be affecting our feeling of pain, can empower us to be unafraid of our own bodies. To know that our bodies are not under attack when we feel pain, that we aren’t damaged goods. That we are, indeed, the most capable, most intelligent, most advanced species in the world.